IDEAS home Printed from https://ideas.repec.org/a/wly/jocnur/v26y2017i17-18p2593-2604.html
   My bibliography  Save this article

Vital signs as predictors for aggression in hospital patients (VAPA)

Author

Listed:
  • Julie Considine
  • Debra Berry
  • Rebecca Johnson
  • Natisha Sands

Abstract

Aims and objectives To examine and describe the relationship between physiological status and violent and aggressive behaviours in hospital patients. Background The majority of adverse events are preceded by physiological abnormalities; whether physiological deterioration is a predictor of violent or aggressive behaviours remains unknown. Design Prospective case–control study. Methods Prospective audit of 999 patients from two major health services in Melbourne, Australia. There were 333 cases who required an emergency response for aggressive or violent behaviour (Code Grey) in the emergency department, medical or surgical units, or inpatient mental health unit between January–June 2015. Two control patients who did not have a Code Grey were randomly selected from the same unit and same day that the Code Grey occurred for the case patient. Results Patient locations were 54·4% medical or surgical units, 23·7% emergency department and 21·9% mental health units. Code Grey patients had less documentation of physiological assessment and were more likely to have respiratory rate, heart rate and conscious state abnormalities in the 12 hours preceding Code Grey. After adjusting for confounders, the risk of Code Grey was highest for patients with confusion. Conclusion Patients experiencing behavioural disturbance had lower standards of patient assessment, greater incidence of physiological abnormalities and more inpatient deaths. Early recognition of, and response to, patient and physiological predictors of Code Grey should be a strategy to prevent behavioural escalation to the point of Code Grey. Relevance to clinical practice Strategies are needed to improve physiological assessment of patients with behavioural disturbance while ensuring staff safety. There are patient and physiological factors associated with increased risk of Code Grey that may be used to prevent behavioural escalation to the point of an emergency response.

Suggested Citation

  • Julie Considine & Debra Berry & Rebecca Johnson & Natisha Sands, 2017. "Vital signs as predictors for aggression in hospital patients (VAPA)," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(17-18), pages 2593-2604, September.
  • Handle: RePEc:wly:jocnur:v:26:y:2017:i:17-18:p:2593-2604
    DOI: 10.1111/jocn.13646
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/jocn.13646
    Download Restriction: no

    File URL: https://libkey.io/10.1111/jocn.13646?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Eddy Adang, 2008. "Economic evaluation of innovative technologies in health care should include a short-run perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(4), pages 381-384, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Adang, Eddy M.M. & Wensing, Michel, 2008. "Economic barriers to implementation of innovations in health care: Is the long run-short run efficiency discrepancy a paradox?," Health Policy, Elsevier, vol. 88(2-3), pages 236-242, December.
    2. Gijs Wetering & Willem Woertman & Andre Verbeek & Mireille Broeders & Eddy Adang, 2013. "Quantifying short run cost-effectiveness during a gradual implementation process," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 911-918, December.
    3. Pauline Chauvin & Jean-Michel Josselin & Denis Heresbach, 2014. "The influence of waiting times on cost-effectiveness: a case study of colorectal cancer mass screening," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 801-812, November.
    4. Sebastian Gurtner, 2013. "An analysis of the influence of framework aspects on the study design of health economic modeling evaluations," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 221-230, April.
    5. Gijs Van de Wetering & Willem H. Woertman & Eddy M. M. Adang, 2012. "A model to correct for short‐run inefficiencies in economic evaluations in healthcare," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 270-281, March.
    6. van Baal, Pieter & Morton, Alec & Severens, Johan L., 2018. "Health care input constraints and cost effectiveness analysis decision rules," Social Science & Medicine, Elsevier, vol. 200(C), pages 59-64.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:jocnur:v:26:y:2017:i:17-18:p:2593-2604. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://doi.org/10.1111/(ISSN)1365-2702 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.